CCO Behavioral Health Program Manager – Adult Mental Health

Are you excited to step into a complex world that requires a blend of mind, heart and flexibility? We at CareOregon have been strengthening communities since 1994 by making health care work for everyone. As a nonprofit health plan largely focused on Oregon’s Medicaid population, we find fulfillment in supporting the underserved.

General Statement of Duties

This position is responsible for providing behavioral health leadership for a Coordinated Care Organization (CCO) for the purpose of improving the quality of care for adults with mental health needs, including the integration of mental health services with the rest of the continuum of care (e.g., substance use, physical health and oral health services). The intended outcome is to ensure the CCO adequately meets the mental health needs of enrolled adult members, regardless of where they primarily receive their care, and that the CCO meets and exceeds its regulatory and quality of care expectations. This position works closely with service provider leaders, CCO leaders, advisory councils and CareOregon’s Behavioral Health team in the areas of network management and optimization, program development, and delivery system change. This role participates in the Behavioral Health Quality Committee.

Essential Position Functions

In partnership with the CCO Clinical Team, leadership, and partner organizations, develop, implement and oversee a Behavioral Health Integration Strategic Plan or initiative that effectively meets member mental health needs regardless of the site where members are seen.
Provide leadership for the development and operation of specific integrated mental health utilization, quality improvement and evaluation programs for members with mental health diagnoses, including the development of new payment and delivery system models.
Assist in the compliance monitoring of provider network to review utilization, quality improvement, and evaluation programs for members within mental health services.
Participate in policy and planning discussions focused on creating increasingly integrated health care delivery models on a community-wide basis.
Collaborate with medical and behavioral health providers in creating systems and protocols that encourage the provision of behavioral supports for improved physical health, including the use of peer wellness specialists.
Guide or partner with behavioral health providers in developing infrastructure to incorporate physical health into behavioral health services.
Influence the development and utilization of IT systems for optimal information sharing between physical and behavioral health providers.
Represent CCO in applicable activities including clinical and other professional organizations. Serve as a representative and spokesperson for the CCO in support of new models of care that integrate mental/behavioral health with physical and dental health.
Provide the leadership necessary to maintain a high degree of engagement from CCO stakeholders, including County partners, behavioral health professionals and providers, advocates, and members through open communication and clear articulation of goals and vision.

Essential Department and Organizational Functions
Propose and implement process improvements.
Meet deadlines for completion of workload.
Maintain agreed upon work schedule.
Demonstrate cooperation and teamwork.
Provide cross-training on specific job responsibilities.
Meet identified business goals that contribute to departmental goals.
Perform other duties as needed.

Knowledge, Skills and Abilities Required

Strong understanding of the clinical management of diverse mental health and co-occurring mental health/addiction issues
Knowledge of the Community Mental Health and Addictions system in Oregon
Knowledge of Behavioral Health managed care practice, including utilization management, population health improvement, guideline development, disease management and cost effectiveness evaluation
Knowledge of applicable regulatory and contractual requirements for Medicaid, Medicare and Commercial insurance, especially as it relates to mental health and chemical dependency, is desirable.
Awareness of provider payment issues, practice models and continuous quality improvement concepts.
Excellent communication and collaboration skills for work with diverse stakeholders
Ability to implement new and improved approaches to improvement of care and service quality
Ability to create engagement and bring individuals together; ability to work effectively as part of a cross-functional team and foster an environment where change is embraced and supported
Management or leadership skills, including the ability to lead and influence clinical and non-clinical staff and teams
Commitment to improving access and quality of care to the underserved and uninsured
Appreciation of cultural diversity and the needs of serving a diverse patient population
Ability to be high-energy, persistent, assertive, data driven and focused
Ability to travel to community-based meetings

Physical Skills and Abilities
Lifting/Carrying up to 0 Pounds

Pushing/Pulling up to 0 Pounds

Pinching/Retrieving Small Objects

Crouching/Crawling

Reaching

Climbing Stairs

Repetitive Finger/Wrist/Elbow/

Shoulder/Neck Movement

0 hours/day

0 hours/day

0 hours/day

0 hours/day

0 hours/day

0 hours/day

3-6 hours/day

Standing

Walking

Sitting

Bending

Seeing

Reading

Hearing

Speaking Clearly

0 hours/day

0 hours/day

0 hours/day

0 hours/day

More than 6 hours/day

More than 6 hours/day

More than 6 hours/day

More than 6 hours/day

Cognitive and Other Skills and Abilities

Ability to focus on and comprehend information, learn new skills and abilities, assess a situation and seek or determine appropriate resolution, accept managerial direction and feedback, and tolerate and manage stress.

Education and/or Experience

Required:

Master’s degree in social work, counseling or related field
Minimum 5 years’ experience as a mental health professional
Preferred:

Licensed Professional Counselor (LPC) or Licensed Clinical Social Worker (LCSW)
Experience working in the healthcare industry, preferably in Medicaid or Medicare
Leadership experience of managed care or other population health, quality and cost outcomes
Experience working with integrated primary care and mental health models
Experience applying innovative and creative approaches to improve health care delivery

Working Conditions

Environment: This position’s primary responsibilities typically take place in the following environment(s) (check all that apply on a regular basis):
☒ Inside/office ☒ Clinics/health facilities (no member contact) ☐ Member homes

☒ Other: Offices outside of region

Travel: This position may include occasional required or optional travel outside of the workplace, in which the employee’s personal vehicle, local transit, or other means of transportation may be used.
Equipment: General office equipment
Hazards: n/a

Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment

Veterans are strongly encouraged to apply.

Equal opportunity employer. This company considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.

Position Description »